Tag Archives: relationships

Journeying through betrayal trauma

By Allan J. Katz and Michele Saffier June 6, 2022

Tero Vesalainen/Shutterstock.com

“Cathy’s” life has just been turned upside down. She picked up her husband’s cellphone only to discover a loving message from his affair partner. Cathy’s brain is spinning, and her emotions are all over the map. She feels embarrassed and alone, disconnected and detached from reality. She questions whether her entire relationship has been an enormous lie. She questions her attractiveness, her sexuality and her ability to ever trust anyone again. She feels as if she were just pushed out of an airplane and fell with no parachute.

As a certified sex addiction therapist and a member of the American Counseling Association, I (Allan) have seen firsthand that betrayal trauma is real. The shock is debilitating for betrayed partners and can last for years. Their lives are broken to pieces, and they are overwhelmed with shame, often thinking, “How could I be so stupid not to realize what was happening right under my nose? I’m such a fool for trusting him/her.” They feel they are going crazy. 

But these feelings are all normal because in all likelihood, this is the most shocking and confounding crisis they have ever experienced. After all, they thought they knew their partner and never thought their partner would cheat. The reality of the situation rocks the foundational values they have believed in and based their lives on. What is perhaps most disturbing is that they were going about their daily routine in the safety of their own home, and, in an instant, a discovery upends their world. It happens through answering a knock at the door, reading a random text, picking up a ringing telephone or — the most common form of discovery — turning on the computer to check email. 

The shock for the betrayed partner is so profound in the first moment, the first hour and the first day that it is hard to comprehend. It feels surreal, as if it can’t be happening. It feels as if you are suddenly outside of yourself watching a movie, seeing yourself react and not feeling connected to your own body. 

International trauma expert Peter Levine explains that when we are confronted by a situation that our brain experiences as frightening, we automatically go into a freeze response. We are thrust into a primal survival strategy commonly referred to as being “like a deer in headlights.” It is the state of being “beside yourself.” Betrayed partners describe it as being frozen, numb or in an altered state. Being lied to in such a profound manner by your partner, lover, sweetheart and beloved feels wholly abnormal. For many betrayed partners, there is no precedent for the experience. 

Answering the ‘why’ question

The “why” question is what betrayed partners find themselves coming back to over and over again. Why did you engage in this behavior? Why did you lie … repeatedly? 

Betrayed partners often feel that they can’t move on and find closure without knowing the answer to the “why” question. The painful truth is that there is no good reason and, for the betrayed partner, no right answer. The “explanation” can be challenging for betrayed partners to hear and can take time to process fully. Although they may not understand the “why” behind the behavior, betrayed partners can gain answers that help provide clarity and make healing possible for them and the relationship.

“Daphne,” a heartbroken partner, described her “why” questions as follows: “What were you thinking? Was I the only one longing to share my life with you? What makes you think you can take a stripper and her child to Disneyland, tell me and then expect me to stand for it? How could you use my faith and religion against me by saying, ‘Aren’t you supposed to forgive? Judge not lest you be judged,’ and, most offensive, ‘I think you were put on this earth to save me.’ Why did you even marry me? Why did you stay married to me? What does love mean to you? You obviously have no heart. How could you look me in the eyes and see how much pain I was in and how unloved I felt and continue giving our money to your girlfriend? Why did you promise me that you would never cheat on me as my father did to my mother? How can you say, ‘It’s not about you’? You admitted to me that you never considered my feelings. Why? You acknowledged that you lied to your family about me, portraying me as a horrible spouse so that you would feel justified to continue your affair. Why did you need to go that far?”

These are the types of questions that every betrayed partner asks. Betrayed partners believe that they cannot heal unless they know why their beloved cheated on them. But in the case of chronic betrayers, their reasons lie deep below the surface, much like the iceberg that sank the Titanic. The question becomes, “Why would someone who appears to be functioning well act against their morals and values?” Are these folks actually addicted to sex, or is sex addiction an excuse for bad behavior? 

In her “What Your Therapist Really Thinks” column for New York magazine on May 11, 2017, Lori Gottlieb responded to a letter from a reader wondering whether their husband might be having an affair. Gottlieb mentioned that whenever someone comes into her office to discuss infidelity, she wonders what other infidelities might be going on — not necessarily other affairs but the more subtle ways that partners can stray that also threaten a marriage.

In his book Contrary to Love, Patrick Carnes said his research indicated that 97% of individuals who were addicted to sex had been emotionally abused as children. These individuals were raised in unhealthy or dysfunctional homes with parents who did not give them the care essential to their healthy growth and development. Poverty, mental illness, alcoholism, drug addiction, violence and crime are among the many reasons that individuals turn to sexually compulsive behavior as adults. As a result, people who are sexually addicted have negative core beliefs about themselves. They feel alone and afraid and believe they are unworthy of love; they believe that no one can truly love them because they are unlovable. Therefore, they learn from a very young age that intimacy is dangerous in real life and that they can trust themselves only to meet their needs. 

In an article titled “Can serial cheaters change?” at PsychCentral.com, psychologist and certified sex addiction therapist Linda Hatch discussed two reasons that people cheat, both due to deep insecurities. Some who cheat feel intimidated by their spouse in the same way that they felt threatened in their childhood homes. A real-life connection is terrifying to someone who was not shown love as a child. In response, they seek affair partners, watch pornography or pay for sex to avoid these real-life connections. 

Carnes’ second book, Don’t Call It Love, is aptly titled. Acting out is not about love or sex; instead, acting out numbs the overwhelming agony of being loved by a real-life partner.  

The root of addiction and the brain science

At the root of addiction is trauma. Trauma is the problem, and for some, sexual acting out is the solution — until the solution fails. And when it fails, it results in more trauma. 

Deep wounds suffered when young cause a level of pain that overwhelms the child. Because human beings are built to stay alive, the brain banishes the ordeal’s worst feelings and memory. It locks them away to keep the child alive. 

Understanding the brain science of trauma and addiction enables the betrayed partner to see the big picture. The acting out had very little to do with the relationship or the partner.

Many mental health professionals do not believe that sex addiction is a legitimate disorder. Therapists often think that the betrayed partner is the problem because they’re “not enough” — not attentive enough, not available enough, not sexual enough, not thin enough, not voluptuous enough. Sex therapists (not to be confused with sex addiction therapists) believe that sexual expression is healthy — regardless of the behavior. Understanding the science that drives the addictive process is vital for the betrayed partner’s wellness, lest they take responsibility for their betrayer’s acting out. Knowing the brain science that causes a process addiction is essential to understanding how something that isn’t a chemical substance can be addictive. 

In his book In the Realm of Hungry Ghosts: Close Encounters With Addiction, Dr. Gabor Maté described childhood adversity and addiction, noting that early experiences play a crucial role in shaping perceptions of the world and others. A 1998 article by Vincent J. Felitti and colleagues in the American Journal of Preventive Medicine explained that “adverse childhood experiences, or ACEs (e.g., a child being abused, violence in the family, a jailed parent, extreme stress of poverty, a rancorous divorce, an addicted parent, etc.), have a significant impact on how people live their lives and their risk of addiction and mental and physical illnesses.” 

There are two types of addictions: substance and process (or behavioral) addictions. Process addictions refer to a maladaptive relationship with an activity, sensation or behavior that the person continues despite the negative impact on the person’s ability to maintain mental health and function at work, at home and in the community. Surprisingly, an otherwise pleasurable experience can become compulsive. When used to escape stress, it becomes a way of coping that never fails. Typical behaviors include gambling, spending, pornography, masturbation, sex, gaming, binge-watching television, and other high-risk experiences. 

Process addictions increase dopamine. Dopamine is a naturally occurring and powerful pleasure-seeking chemical in the brain. When activities are used habitually to escape pain, more dopamine is released in the brain. The brain rapidly adjusts to a higher level of dopamine. The “user” quickly finds themselves on a hamster wheel, seeking more exciting, more dangerous, more erotic or more taboo material to maintain the dopamine rush. The brain has adapted to the “new normal.” The brain depends on a higher level of dopamine to regulate the central nervous system. It quickly becomes the only way to reduce stressors; the person struggling with addiction ends up doing and saying things they will soon regret but cannot seem to stop on their own. Carnes aptly refers to this as the hijacked brain.

Once the brain is hijacked, the downward spiral of craving more and more dopamine affects higher-level thinking and reasoning. 

Let the healing begin

Healing for the betrayed partner begins with a formal disclosure process, ideally guided by certified sex addiction therapists. Betrayed partners often have difficulty making sense of their reality on their own. There are so many unanswered questions, and each question has 10 questions behind it. 

Betrayers are reluctant to answer questions because they fear the answers will cause the betrayed partner more harm and therefore will cause them harm. However, withholding information is what causes harm. Betrayed partners report difficulty getting the whole truth on their own. Even if their betrayer does break down and answer questions, they will not get the entire story because the betrayer is in denial — they are in denial that they are in denial! 

A formal disclosure process led by a certified sex addiction therapist is the best way to get the information necessary so that the betrayed partner can make the most important decision of their life: Will they stay in the relationship or leave? 

Partners who continue to be consumed with seeking information are tortured — not by the behavior but by their unrelenting quest to uncover all of the lies. Initially, information-seeking helps decrease panic and the horrible loss of power experienced after discovery of the betrayal. However, searching for information or signs of acting out quickly becomes all-consuming. Without intervention, intense emotions lead to faulty thinking, which becomes a force from within that fuels anger, rage and revenge. The powerful energy inside can be like a runaway train gaining speed until it crashes.  

Betrayed partners learn that betrayers live in a state of secret destructive entitlement. Education about the conditions that led to the betrayer’s choices and deception is essential for the betrayed partner’s healing. Still, it is in no way a justification or vindication of the betrayer’s egregious behavior.

It is complicated to understand that there are two truths for people who struggle with sex addiction: they love their partner (in the way they know love) and act out sexually with themselves or others. Betrayed partners come to understand that addiction is a division of the self. 

Reflection and reconstruction 

Betrayal trauma causes a fracture in the foundation of a relationship and the foundation of the self. The secrets, lies, gaslighting and deception throughout the relationship are a silent cancer that consumes the infrastructure. The most devastating aspect of discovery is that the entire system that holds the relationship together begins to collapse into itself.  

For the betrayed partner, healing involves self-reflection. Although they didn’t create the problem, their mental health requires them to face aspects of themselves that have been affected by infidelity and deception. During therapy, both partners face reality and let go of the illusion that theirs was a healthy marriage/relationship. They grieve what was lost and learn to let go of anger. Letting go creates space to build inner strength and accept love back into their hearts.  

Forgiveness

Healing of the mind, heart and soul can happen regardless of the magnitude of the deception. But in the absence of a healing/recovery process, the betrayed partner’s anger intensifies and can cause them to be further traumatized by sifting through emails, texts and conversations, asking for every minute detail of the affair. As anger ferments, it can lead to rage. Rage can wreak havoc on the body, leading to health problems. 

The solution is forgiveness. Many partners worry that they will be expected to forgive their betrayer. But forgiveness is not about forgetting nor is it about condoning bad behavior. Instead, forgiveness is a process of opting out of anger and the need for revenge — forgiving the human qualities that lead people to act in terrible ways. To be clear, forgiveness frees one’s heart from the prison of anger. Forgiveness is a decision that is made daily.

Release and restoration

After discovering a beloved’s infidelity and deception, and after accepting their own call to action, the betrayed partner turns inward and begins their own hero’s journey. This journey requires courage, loyalty and temperance. Each phase of the journey involves purifying, grinding down, shedding and brushing away unhealthy attitudes, beliefs and behaviors. The hero’s journey brings the betrayed to a state of purity and clarity. 

Eckhart Tolle described the “dark night of the soul” as a collapse of the perceived meaning that the individual gave to their life. The discovery of infidelity, deception and trickery causes a shattering of all that defined the betrayed partner’s life. Their accomplishments, activities and everything they considered important feels like they have been invalidated. 

At the bottom of the abyss, however, is salvation. The blackest moment is the moment where transformation begins. It is always darkest before the dawn. The only way to heal is to head straight into the fire toward restoration. 

The restoration phase is all about finding meaning in life again. This doesn’t mean the betrayed partner will no longer have any feelings of sadness or longing. But they will also have moments of happiness again. 

There are two tasks in this last phase of the hero’s journey: reclaiming their life with a new story that includes the bruises and scars bound together with integrity and pride, and restoring one’s self to wholeness. Before putting it all back together, partners must find their meaning in their own personal hero’s journey. To accomplish this, partners must discover how to make meaning out of suffering. 

In his book Man’s Search for Meaning, Viktor Frankl, a Holocaust survivor, asserted that even in the worst suffering, having a sense of purpose provides strength. He contended there is no hope to survive if suffering is perceived as useless. Finding purpose transforms suffering into a challenge. 

Frankl believed that in the worst of circumstances, there are two choices: 1) to assume that we cannot change what happens to us, leaving our only option to be a prisoner of our circumstance or 2) to accept that we cannot change what happened to us but that we can change our attitude toward it. A more potent, resilient, and positive attitude allows us to realize our life’s meaning. Through their hero’s journey, betrayed partners learn that their brokenness can lead to wisdom and deeper meaning in their lives.

 

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Allan J. Katz is a licensed professional counselor and certified sex addiction therapist. He is products co-chair at the Association for Specialists in Group Work and has written five books, including Experiential Group Therapy Interventions With DBT. Allan is the co-author, with Michele Saffier, of Ambushed by Betrayal: The Survival Guide for Betrayed Partners on Their Heroes’ Journey to Healthy Intimacy. He can be reached on his website, AllanJKatz.com.

Michele Saffier is a licensed marriage and family therapist and a certified sex addiction therapist and supervisor. As clinical director and founder of Michele Saffier & Associates, she and her clinical team have worked with couples, families, betrayed partners and people recovering from sexually compulsive behavior for 24 years. As co-founder of the Center for Healing Self and Relationships, she facilitates outpatient treatment intensives for individuals, couples and families healing from the impact of betrayal trauma. She can be reached at her website, TraumaHealingPa.com.

 

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, visit ct.counseling.org/feedback.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Mental gymnastics: Navigating challenging relationships

By Grace Hipona May 13, 2022

“I am not sure how they are feeling and what they are thinking. I am confused. I feel like I am going crazy. I question everything, and I don’t know if I can trust what I am feeling and thinking.”

Relationship issues are one of the more difficult problems to help clients manage. When clients make any of the statements above, especially in relation to someone else, I talk with them about what I have coined as “mental gymnastics.” Mental gymnastics can start with unsettling statements and questions but also can lead to impacting other areas of a person’s life. In this article, I discuss how clients can be affected and strategies professional counselors can use to help them navigate these challenges.

Direct communication

When a client is experiencing mental gymnastics, they may commonly ask, “Why is this so hard? Why can’t I make this work? Why is this so exhausting?”

Direct communication, including asking questions, is the best strategy for clients to navigate mental gymnastics. However, if direct questions are asked and the other party does not respond with an honest or genuine answer, then it becomes more complicated. Sometimes, there is a discrepancy between what a person says and how they act. Sometimes, they may not even have this awareness, especially if they are confused themselves.

Unfortunately, it may feel purposeful or malicious when others do not communicate directly, lie through omission or engage in other forms of dishonesty. A classic example is when a person asks, “How are you?” and the other person responds with “I am fine.” However, their body language and tone of voice indicate that they are not actually “fine” but are instead upset or angry. Another common exchange is one person asking, “Do you need anything?” and the other person responding with “no,” even though they need help.

When discrepancies between what clients say and how they act arise, it is natural for clients to question their own inclinations. “Can I trust how I feel or what I think?”

Adding to the internal conflict, the other person can potentially invalidate how the client feels or completely deny their reality. Therefore, as professional counselors, it is important to specifically ask clients their feelings about the relationship in question. This clarity can increase clients’ self-awareness. Clients will find it easier to navigate relationships when they are aware of their reality and have confidence in it.

Good vs. bad anxiety and needs vs. wants

One common example of mental gymnastics that I’ve encountered is when a client has begun getting to know someone (whether a budding friendship or a romantic relationship) and they experience anxiety that is more constant and intense than typically associated with relationship building. This is when clients may begin having unsettling questions and statements: “Why can’t I tell if they like me? I can’t seem to get a straightforward answer. I don’t know what they want.”

When this occurs, I help clients differentiate “good” versus “bad” anxiety. In other words, I provide a space for them to process how they perceive the adrenaline associated with their experiences. A person should experience levels of anxiety when meeting someone new and getting to know them. This could be perceived as “good” anxiety or excitement. Clients may feel butterflies in their stomach, brighter in their affect, and hopeful. With good anxiety, clients may have thoughts and questions such as, “Do they like me?”; “Did I make a good impression?”; and “I can’t wait to see them again.”

If clients experience “bad” anxiety, such as excessive worry, irritability, dread and the triggering of the “fight, flight or freeze” response, this may be a red flag. They may have thoughts such as, “I don’t know what to do”; “I can’t seem to say anything right”; and “What can I say or do so that they will like me more?”

In helping clients assess whether they are experiencing “good” versus “bad” anxiety, I ask them if in general they feel more positive emotions than negative ones. For example, “Do you feel happier more than 50 percent of the time?”

I also help clients determine their needs and wants. I describe needs as things that are non-negotiable to them, such as respect, trust, honesty, marriage, children, and religious or spiritual beliefs. Hard boundaries need to be set around these needs.

Wants are negotiable or flexible. Examples include physical appearance, financial status, educational background and geographic origin. When it comes to positive and healthy relationships, clients should have their needs met, and the relationship should feel like it is a “want” or a choice.

LinaDes/Shutterstock.com

Minimizing and denying

The answers to the assessment questions in the previous section can be interrelated and could lead to more confusion. For example, clients could determine that they feel happy most of the time with their relationship but that most of their needs are not being met. This discrepancy can cause clients to question their feelings, and this could lead to an increase in anxiety.

Another potential cause of internal conflict is receiving information from the other person that minimizes or denies the client’s experience. For example, the client may be questioning their own reality because the other person is directly challenging it: “Oh, you shouldn’t feel that way. Are you sure?”

The other person could be completely denying the client’s reality: “That didn’t happen. I know what you’re feeling. You’re not really mad.”

Some may even define this as “gaslighting” (questioning their internal reality or “sanity” based on external pressure and manipulation).

Another example that can cause internal conflict is when the client brings a concern or stressor to the other person, and that person minimizes the client’s experience. The other person might respond with, “You’re making a big deal out of nothing, and you shouldn’t feel that way.” The other person may shift the focus to themselves while minimizing the client’s experience, “You think you’re upset? I’ve felt so much worse. You don’t know what suffering is really like.”

In any of these scenarios, the attention has turned toward the other person, and the client’s thoughts and feelings have been dismissed. In other words, the client is then reactively directing their energy toward the other person, and the client has lost sight of their inner experience. The client could be more likely to “lose themselves” in the relationship and, therefore, not get their needs and wants met.

Like the sport, mental gymnastics requires a person to use energy and effort. However, unlike the sport, mental gymnastics unnecessarily uses a person’s energy. One indicator that clients are engaging in mental gymnastics is that they feel tired and their mood is generally lower than usual. Clients may describe feeling “drained” even though they are not actively and purposefully using their energy. They may feel the need to use certain strategies or efforts to engage with a particular person. Clients may feel the need to “perform” a certain way; otherwise, they may feel judged, criticized and denied any love, support, care or validation from the other person. Clients may feel dueling inclinations of needing to spend time with the other person but also wanting to avoid that person.

Another reason clients may unnecessarily use energy to engage with another person is that even when trying to support this person, clients feel like they “can’t win.” In other words, the intention and effort may be there, but the other person still feels “it is not good enough.” Even if conditions are met, the other person may find something wrong with what has happened. That person may say, “That was a nice try, but I would have liked this instead.”

Aside from helping my clients gain clarity over their needs versus their wants and insight into their internal experience in general, I believe it is important to help clients reality test. Writing a “pro/con” list or something similar can be useful, especially for clients who tend to be visual in nature. Asking the following questions can support development of this list:

  • How do you benefit from this relationship?
  • How does this person meet your needs and wants?
  • How do you feel about them?
  • How do you feel about the relationship?
  • How is your life impacted by this person?
  • How do they challenge you to be the best version of yourself?
  • What do you like about this person?
  • What do you dislike about this person?
  • What do your friends and family think about this person. 

Active and reactive decision-making

After time, effort and space have been given to the questions mentioned in the previous sections and clients continue to move forward in a relationship where mental gymnastics is present, I encourage clients to think about the consequences of this choice. At this point, clients can take ownership and feel empowered by their decision-making.

When I work with clients, I focus on strategies to help them make ACTIVE decisions rather than reactive ones. Once there is a level of insight into decision-making, they can make informed decisions. This awareness can lead to active decisions where the clients feel they have a choice. Without any awareness, clients may not feel like they have a choice. They may feel compelled to do something but not know why.

An example of a reactive decision is when a client chooses not to end a relationship even though there is evidence that the relationship is unhealthy. A client may say, “I don’t want to break up with him because I love him.”

As the client’s counselor, I would ask, “Why do you love him?”

The client may respond with, “I just do” or “I am not sure, but this is how I feel.”

If clients continue making reactive or passive decisions, this can perpetuate or exacerbate negative anxiety. Counselors can assist in exploring the client’s decision-making process so the client can answer the question “why?”

I believe when clients experience anxiety, it is not just their fear of the unknown and the byproduct of internal conflict, but also a result of them not feeling empowered in their own lives. For clients to feel empowered, they need to be an active participant in their own decision-making process. Counselors can help clients manage this anxiety by helping them focus on their locus of control.

Clients can examine what they say and how they act toward the other person. They can focus on their self-care and on other important aspects of their identity. Clients can also concentrate on purposefully coping with their anxiety in healthy ways. These strategies can lead to feeling confident in navigating potential mental gymnastics.

 

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Grace Hipona is a licensed professional counselor for NeuroPsych Wellness Center PC and holds a doctorate in counselor Education and supervision. Her dissertation focus was on disaster mental health, specifically sheltering-in-place. She is also a certified substance abuse counselor and approved clinical supervisor. Her experiences over the past 15 years include working in private practice, managing behavioral health programs, teaching graduate students, and providing supervision for master’s-level counseling students and counselors-in-residence. Contact her at ghipona@hotmail.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Real talk

By Peter Allen December 13, 2021

I love doing couples work. It is endlessly fascinating, usually challenging and often rewarding. It is a privilege and a sacred responsibility to sit in a room with two people who are both bearing their souls to each other with the shared goal of improving their relationship. When I ask couples what their goals are early on in therapy, more often than not, they tell me they wish to communicate better.

At first glance, this seems like an easy task. Many couples who come to counseling have been experiencing a lot of conflict in the relationship, and their communication might typically include yelling, insults or perhaps passive-aggressive statements and various forms of manipulation. It is very tempting to think that if we can teach them to use “I” statements and a calmer tone of voice and to verbalize feelings and perceptions rather than insults, then loving harmony will follow. It is in fact so tempting to believe this that we may ignore much of what we know about human behavior and biology in the pursuit of facilitating these relational improvements.

It is also alluring to believe that helping people improve their communication is largely a data-driven endeavor. In other words, I have information (data) as a counselor that they don’t have, and if I simply impart this information to them, they will “learn” it, and then their relationships will improve. In reality, improving communication is much more process-oriented, which means that being effective involves observing conditions in real time and constantly responding to those dynamics.

I spent far too much time as a professional counselor simply trying to give people the right words to say, and I suspect that many of my colleagues have had a similar experience. But what I have found time and time again is that many of our clients show up to a session perfectly capable of communicating well (and here’s the catch) when they are calm. In my own practice, I have discovered that emotional regulation skills are absolutely integral to good communication. I can have the prettiest, most assertive words in the world for my partner, but if my lid is flipped and I am dysregulated, it will not matter at all.

It merits mentioning that certain qualities and attributes we may wish to develop as human beings really count only when something important is at stake. For example, let’s consider the quality of patience. It is very easy to be patient when we don’t have to wait or when we feel no stress or pressure to get something done. But patience means having the ability to wait with equanimity regardless of what other factors are present. Patience is the quality of not getting upset when you have to wait for something.

Another example is the quality of loyalty. It is the easiest thing in the world to be loyal when you don’t have to sacrifice anything. True loyalty can be known only when something of value is sacrificed to maintain that loyalty. If you want to know who your loyal friends are, become a social pariah and see who still comes to your birthday party. Spoiler alert: That number will be less than 100% of your total friend group.

Techniques must work in real conditions

We understand patience as waiting calmly, regardless of the other factors. We know loyalty to mean that one stands by their friends or co-workers, even when that standing comes at a personal cost, such as missed opportunities or alienation from others. And so shall we know and recognize good communication skills when they are used in moments of difficulty.

This is important to restate and remember: Anyone can communicate well when they are calm, stable, well-fed, comfortable, etc. However, when those conditions are present, we rarely need to practice good communication skills. 

When I work with couples, it is not usually the case that both parties in the room feel completely calm or at ease during the session, because difficult and very personal subjects are routinely discussed. My clients live in the real world, and their relationships are with real, complicated, conflicted human beings. They have children, they have blended families, they have traumatic experiences and upsetting memories, and all of those elements can be front and center in a session. The most important time we need to communicate well is when we are unhappy or insecure or angry or tired because this is exactly when poor communication can create additional problems.

At first, couples will not remember to use “I” statements when they get triggered because using “I” statements requires the prefrontal cortex to be online and operational. If we teach people the right words but not the methods to access those words, then we are in effect placing positive communication habits in a museum, making them something to be observed and admired but not held and utilized. Weaving together the right words and the emotional regulation techniques that allow those words to be accessed is critical to helping couples actually implement positive communication tools in their daily lives — when it counts.

Practice, practice, practice

We also need to help our clients develop a consistent communication skills practice, regardless of variations in their moods and responsibilities. Think of it this way: If you want to get good at shooting free throws, you practice when you’re happy and when you’re sad and when you’re bored. You practice in the sunshine and in the rain. You shoot so many free throws that muscle memory develops and outside conditions no longer play much of a factor in how you set up and take the shot. You control what you can control, and you let go of what you cannot control. That is what makes a great free throw shooter. Becoming a skilled communicator is no different.

When we help our clients develop a practice of positive communication skills in any situation, they become good at positive communication in any situation. Weird, right? When couples are experiencing wonderful times together, we encourage them to share feelings and impressions. We prompt them to recognize and praise their partner’s efforts and to ask for what they need. Just as with any training, the best practice early on is done in low-pressure situations to build confidence. 

Over time, people develop greater skills and habits, and the increased communication provides ongoing context for each partner to observe and consider. And, often, context is the great equalizer in couples therapy. When we know what our partner is experiencing, we are much more likely to consider it and respond compassionately than when we have no idea. 

The more couples practice this in various mood states and settings, the more likely they will be to access these skills when they really need to, during times of great difficulty. We should also encourage them to share feelings, impressions and needs when they are bored, mildly annoyed or at their wits’ end because, well, that’s life sometimes too.

I share this at some point with almost every couple I work with: If you make your partner guess what you need, they will get it wrong. If you tell them what you need, they have the best chance of giving what you need to you. Help your clients develop the practice and habit of asking for what they need, when they need it. This aspect alone will reduce conflict noticeably because so much conflict is centered on partners attempting to ascertain the needs of the other and getting it wrong. 

Conversely, in the absence of any specific dialogue about the needs of the other, it is easy to forget for short or long periods of time that our partner would need anything at all from us. But when our partner shares and we hear what they need, we can respond to that.

Building positive communication habits

There are many ways we can help people integrate these concepts and habits into their lives. Emotional regulation can be as simple as prompting someone to take a few deep breaths while they contemplate what they want to say or asking them to let the weight of their body acquiesce to gravity and simply relax down toward the earth. 

I usually ask people to identify the emotion they are experiencing and see if they can rate its strength on a scale of 1 to 10. We can ask them if they feel any sensations in their body and any associated emotions or thoughts, bringing about mindfulness of their own state prior to communicating. 

I am inviting them to tune in to their own experience and tell me what they are noticing in terms of any conditions that are present. Because if they are noticing things about how they are thinking and feeling, then we know that the prefrontal cortex is working. And all of this is about slowing down and creating some opportunity for self-reflection prior to dialogue. It’s not something we need to overthink; most people will have a sense of when they are functioning well and can communicate well and when they might not be, if we direct their attention toward these factors.

I love using normal cues in the day to prompt practice. Many people eat three meals a day, so they consistently have three natural stopping points in the day to practice some of the skills discussed above. I will say to a client, “How about during lunch today, you praise your spouse for supporting you?” or “Try asking for what you need at dinner tonight, even if it is something small.” 

We could prompt the use of a specific skill at any natural point in a client’s day. And we can encourage clients to be transparent, even telling their partner that they are deliberately practicing skills and would appreciate their support with those efforts (very cleverly practicing two skills at once). Their partner sees them practicing and investing in better communication, and that can be contagious.

I encourage clients to communicate well when they can or to take some time apart and buy themselves some time when they can’t. I have never heard an emotionally regulated person call their partner a harsh name or deliberately insult them in session. I have heard plenty of dysregulated people do that.

At the macro level, we know American culture places a high value on fixing problems, but at the micro level, many of us are less adept at assessing when we lack the proper tools to fix any given problem. At the risk of using too many metaphors in one article, one should not attempt to climb a mountain on an empty stomach or without water. And couples should not attempt to problem-solve serious relationship issues when they are hungry, hurt, exhausted or otherwise low on personal resources. 

When it comes to having conflict with a partner, a persistent myth exists that it is wise and desirable to “hang in there.” Let me state this unequivocally — it isn’t. It is far wiser to disengage, before additional damage is done, than it is to stay in the conversation when it is clear that neither person is giving any ground or understanding the other. 

If my anger is an 8 on a scale of 1 to 10, that is not the best time for me to speak with you. If I want to perform reasonably well, I should probably get my anger down at least to a 4 or a 5 before I re-engage in a discussion. My task is to recognize that in myself ahead of time. Because I cannot wait until I have no feelings whatsoever to communicate, I am always trying to find that sweet spot when I am regulated enough to communicate well. 

This is more important than any particular arrangement of words that we can teach our clients. Part of helping couples improve their communication skills is helping them pick their moments. Just as climbing a mountain should be attempted from a position of confidence and strength, so should problem-solving and conflict resolution flow from this position in couples work.

The important thing for us to keep in mind is that without emotional regulation and consistent practice, attempting to improve communication will be very difficult. Pretty words will not be enough.

Prostock-studio/Shutterstock.com

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Peter Allen is a licensed professional counselor and writer based in Redmond, Oregon. Contact him at peterallenlpc@gmail.com.

 

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, visit ct.counseling.org/feedback.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Growing percentage of American adults are living single

By Bethany Bray December 1, 2021

A growing share of American adults are living the single life.

The Pew Research Center found that in 2019, 38% of American adults between the ages of 25 and 54 were not married or living with a romantic partner. This number has increased significantly in the past two decades, with only 29% being unpartnered in 1990. While this population includes individuals who are divorced, separated or widowed, an increasing portion have never been married.

The number of married adults fell from 67% to 53% between 1990 and 2019, and the percentage of people who were cohabitating with a partner rose slightly from 4% to 9%. Also, the share of adults who have never been married jumped from 17% to 33% during that time period.

Men are more likely to be unpartnered than women, Pew reports. However, the one exception to this rule is among Black women, with 62% of Black women and 55% of Black men living without a spouse or romantic partner.

Overall, the race and ethnicity breakdown for Americans ages 25 to 54 who were unpartnered in 2019 was as follows:

  • 59% of Black adults
  • 38% of Hispanics
  • 33% of whites
  • 29% of Asians

This evolution of Americans’ living arrangements has also laid bare the financial and other disparities that exist between coupled and single adults. Pew found that adults who live without a partner earn less (on average) than coupled adults, are less likely to finish a bachelor’s degree and are more likely to be financially unstable or unemployed. Single adults’ median salary is $14,000 less than coupled adults, Pew reports.

These statistics create many questions for the counseling profession, including the emotional and relational needs that might arise among single individuals, says Katherine M. Hermann-Turner, an associate professor in the Department of Counseling & Psychology at Tennessee Technological University whose doctoral cognate was in couples and family counseling.

“Many counselors are likely seeing unpartnered clients or family members of unpartnered individuals for services, but what do we know about the stressors of this demographic? … The first step is [for counselors to have an] awareness that this is a growing demographic,” says Hermann-Turner, a past president of the Association for Adult Development and Aging, a division of ACA. “My antenna as a counselor, particularly someone who operates from a systems perspective and relational-cultural theory framework, goes to the potential increased need for emotional connection for unpartnered individuals rather than the economic stressors faced by this demographic.”

In addition to the financial and economic disparities, Pew also found that unpartnered adults were more likely to be living with their parents than adults who are married or cohabitating. Thirty-one percent of unpartnered men and 24% of unpartnered women lived with at least one parent in 2019, which is much higher than that statistic for partnered adults (2% for both men and women).

Hermann-Turner notes that this information raises further questions about what clients who fall into this demographic might need when working with a professional counselor.

“Are these individuals substituting the support of their family of origin for partnership or reliance on external systems of support (i.e., romantic partnership)?,” she asks. “If so, why is this the route for many individuals given the typical complexity of a family system? Is this evidence of an earlier lack of career guidance? Underdeveloped relational skills? If so, how can we as counselors begin to intervene earlier and develop these skills in a younger population? Should we be reconceptualizing family counseling to include an emphasis on adult children and their parents? … I am intentionally avoiding the ‘chicken or egg’ argument and pondering the possibility that enmeshed family systems have intentionally stunted one child’s ability for emotional independence as a way to serve the needs of the parents.”

Olga Strelnikova/Shutterstock.com

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What do you think? How might these demographic shifts affect the work counselors do with clients? How should the profession adapt to help clients and meet their needs?

Add your thoughts in the comment section below.

 

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Read more from the Pew Research Center: https://pewrsr.ch/3DeLtrm

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

When the behavior of others negatively affects clients’ mental health

By Bethany Bray June 1, 2021

In a 1624 devotion, the English poet John Donne argued, “No man is an island, entire of itself; every man is a piece of the continent, a part of the main.” 

This sentiment still rings true in modern-day counseling. Behaviors exhibited by other people in clients’ lives — often the people they love most — can affect them acutely. When these patterns are codependent, manipulative or unhealthy, it can cause clients’ presenting issues to worsen, stall their progress in counseling or otherwise negatively affect their mental health.

Examples run the gamut from an adult client whose parent deals with anxious feelings by being critical of or over-involved in the client’s life to a client whose spouse has experienced past trauma and is prone to angry outbursts.

These types of scenarios are not uncommon, and they often surface as counselors and clients begin to unpack the issue(s) that brought them into therapy, says Jen Ohlund, a licensed associate counselor (LAC) who counsels adolescents and adults at a practice in Mesa, Arizona. One indicator that a client is not getting the support they need from the people in their life can be failure to make progress in counseling, despite hard work on the part of both the client and counselor.

In counseling, a practitioner might hear clients make statements such as “I feel like I’m getting better, but I go home and I keep being told the same [unhealthy] things over and over again” or “I am doing everything I can and nothing is changing,” Ohlund says.

“Any progress they’re making is being shot down by the other individual,” she explains. “That’s when we introduce boundaries. We talk about what a healthy boundary is and equip them with [psychoeducation] that we can’t control how other people react. We can’t always walk on eggshells. Sometimes other people have to work through their triggers, and if they’re not going to do that, we have to set boundaries.”

Fizkes/Shutterstock.com

Seeing the whole picture

Empathic listening and validation from a counselor can serve as important first steps with clients who are wrestling with guilt, aggravation, sadness or other feelings spurred by the behavior of loved ones, Ohlund says. Simply talking through what has and hasn’t been working can be powerful, as can receiving assurance from a counselor that many people struggle with similar challenges and the client is not alone in feeling those same emotions.

“A lot of times, they don’t want to feel this way. They care and love this person,” says Ohlund, a member of the American Counseling Association. “They might feel overwhelmed [or] frustrated with their loved one or turn inward and beat themselves up, feeling like they’re not doing something right [or] not doing enough to meet [the other person’s] needs.”

Counselors can also listen for indicators that clients are struggling with isolation, a lack of boundaries (such as receiving an extremely high number of text messages from a family member) or feelings that they can “never say no” to their loved one. In these cases, clients might not have other people in their life who can act as a sounding board to give them a clear perspective. One way counselors can help clients temper the unhealthy messages they receive from a loved one is to support them in finding connection with other people who offer positivity and a voice of clarity. This will help clients self-regulate, Ohlund notes.

Michelle Fowler, an LAC at the Arizona Center for Marriage and Family Therapy, urges counselors to help these clients through an attachment lens. “We are wired to need one another and respond to one another. Doing therapy in a bubble is very unrealistic,” Fowler says. “The relationships around the client have the greatest influence on their well-being. It’s neglectful of us to ignore those contacts or not address them when they are a source of [a client’s] distress or, potentially, a resource to help in recovery.”

Asking targeted questions during the intake process is a good way for clinicians to get a picture of the supportive factors in a client’s life, says Breanna Lucci, a licensed mental health counselor at a group practice in the North Shore of Massachusetts. These questions can include:

  • Who is in your support system? Who can you turn to for support?
  • Who makes you happy?
  • What are your standards in a relationship, and how do you know a relationship is a healthy one?
  • Does your family know that you’re going to therapy, and are they supportive of that decision?
  • Describe your living environment. Is it supportive?
  • Who (other than your counselor) are you comfortable talking to about topics related to mental health?

Lucci also finds that discussions about a client’s self-talk can uncover outside factors affecting their mental health. She uses motivational interviewing with clients to delve deeper into these external influences.

For example, if a client says, “I’m anxious, but I just need to get over it,” then Lucci, an ACA member, asks, “Why do you feel that way? Where have you heard that?” Or if they say, “I’ve been told I’m stupid,” then she breaks down what “stupid” means to the client and asks, “Who said that? How did it affect you?” Talking through a client’s language choices in this way helps them to recognize patterns and realize how things they have heard from others and internalized have become part of their self-talk and self-belief. The goal of this work, Lucci stresses, is always for the client to get to these realizations on their own.

Carrie E. Collier, a licensed professional counselor who specializes in Bowen family systems theory at her Washington, D.C., practice, agrees that the language clients use in session about their relationships can relay valuable information about the client’s context and how they respond to others.

“An individual is not in a vacuum — there’s always reciprocity in relationships,” says Collier, director of the Bowen Center for the Study of the Family in Washington. “Anxiety is contagious; if a person is living with other people, there are a lot of shared emotions that are going on. I try and help a person get really clear about what’s theirs and what’s the other person’s, and what he or she is putting into it and what [others] are putting into it. … As a counselor, it’s important to see the [client’s] entire context and the landscape. It’s not just one person sitting in the office with me. It’s not a cause and effect. It’s relationships and people reacting to one another, and that is what the counselor and the client are up against.”

Fostering understanding

With those who are surrounded by unhealthy patterns, it is vital for counselors to be aware of resources (both in their local area and online) that can help clients better understand what their loved one is going through and support the client outside of counseling sessions, Lucci says.

As a licensed drug and alcohol counselor, Lucci is knowledgeable about numerous addiction resources in her area, including a recovery center that offers interventions and free family workshops. She often recommends Johann Hari’s TED Talk, titled “Everything you think you
know about addiction is wrong” (see bit.ly/3aqbpV4), to clients whose family members struggle with addiction. She also has a ready list of organizations that offer support groups and other resources to help those whose loved ones live with mental illness or who struggle with parenting issues, caregiving roles, work stress, an incarcerated loved one and a range of other challenges. The support groups and educational materials from the Depression and Bipolar Support Alliance (dbsalliance.org) and the National Alliance on Mental Illness (nami.org) can be particularly helpful, she adds.

Finding avenues of safe support outside of counseling equips this client population to “be healthy in spite of their circumstances, and some of that is [learning] acceptance,” says Fowler, who counsels adolescents, individual adults and couples. Understanding the big picture that frames a loved one’s behavior (including, in some cases, mental illness) empowers clients and can help them “gain empathy or understanding so it doesn’t feel like a personal attack,” Fowler explains. 

Roughly one-third of Fowler’s caseload is adolescents, and for these clients, questions about the adults in their life can reveal important information about the support they are — or aren’t — receiving at home, she says.

“One place that I always start, especially with the adolescents I see, is the assumption that if they could go to the adults in their circle to deal with their [presenting] problem in a supportive way, they probably wouldn’t be in my office,” says Fowler, an ACA member. “Sometimes it turns out the parents have mental health issues and the client is doing as best as can be expected. It is definitely not happening in a vacuum. … If somebody else really is why, or part of why, they are struggling, is that a person who could be involved in therapy? Is this a person who could potentially help, or does the client need coping skills to deal with [this person]? If it’s a parent and child, I definitely want the parent to come in as much as possible. But if that parent isn’t going to be a safe person because they have their own struggles or are not willing to adjust, be open and see [the] child’s perspective, then how do I shore up [the client] with coping strategies?”

One example Fowler has seen among her caseload is clients who identify as LGBTQ and “have gotten very clear messages from their family that they’re not open to talk about it.” These clients are left to work through their identity and mental health issues on their own — an experience she describes as a “personal journey of how to make peace with themselves while staying in their current environment.” 

For couples and individual clients, a dose of honesty from a counselor about how much their situation could improve may be called for, Ohlund notes. “We [counselors] don’t necessarily give advice to clients, but I also think it’s important to be clear that in some situations, if you continue to stay in this relationship, this is what it will look like. If you learn all of these coping skills and boundaries and nothing else changes, the relationship won’t be better. You can maintain the relationship and be stable, but thriving is a completely different thing,” Ohlund says. “It’s important not to be vague. Be very clear [about] what it would look like if they chose different options so they can weigh it appropriately.” 

Even as clients grow through counseling, the other person in the relationship may not change. This concept is so important, Ohlund points out, that it is written into the informed consent forms at the practice where she works.

“This is one of the most difficult parts of therapy: When you grow and develop, the people around you may not,” Ohlund says. “Once [clients] learn coping mechanisms, communication skills and begin to feel more confident … they may find that the relationships around them change, or they may not even want [those relationships] in their life” any longer.

Counselors can serve as vital resources to help these clients work through self-judgment, anger and other feelings, while equipping them with coping mechanisms such as mindfulness, self-care and self-compassion exercises, Ohlund says. She acknowledges that helping clients learn to see things through a new, healthier lens takes time. Along the way, it is important to help clients focus on the things in their life that are going well, she says.

Rewriting unhealthy patterns 

Fowler once worked with a teenage client whose presenting issues were depression, self-harm and suicidal ideation. The client’s parents had gone through a tumultuous divorce seven years prior, and her father had since remarried. The parents had 50-50 custody of the teen and continued to squabble, sometimes in front of her.

The environments at her mother’s and father’s homes were opposite. The only communication she received from her father involved correction or discipline. His home had much stricter expectations around behaviors and schedules than her mother’s home did, and the client also had stepsibling relationships to navigate at her father’s home. Because the client’s friends lived closer to her mother’s home, she had more opportunity and freedom to connect with her peers when staying with her mother.

The teen was “upside down” on whom she could trust, Fowler recalls. She was exhibiting attention-seeking behaviors online and had been hospitalized for suicidal ideation before Fowler’s work with her. 

Fowler took a different approach from the teen’s previous therapist, who had not involved the parents in the counseling sessions. Fowler focused on rewriting the parent-child and parent-to-parent communication and response patterns that had become unhealthy. She also invited the client’s mother, father and stepmother into counseling, first in a group session without the client and later with one of the adults in sessions with the client.

Fowler used emotionally focused therapy with the teen to help her learn to explain what she was feeling to her parents. The method focuses on exploring primary emotions and practicing communication of those emotions in a way that the client’s attachment figure can receive, Fowler explains. By helping the client share — and the parents truly hear what she was saying — the mother and father were better able to understand the seriousness of their daughter’s depression and the impact their discord was having on her. This experience also tapped into her father’s empathy and allowed him to put his anger aside, Fowler recalls.

Fowler also worked with the adults on how to respond to their daughter in helpful and supportive ways. “I explained that [she] is looking for support and safety and is not feeling loved or feeling approved, so she’s looking for it elsewhere,” Fowler says.

The parents agreed to stop arguing in front of the teen, and the father had a change of heart and began to plan activities to be able to spend time with his daughter in a positive way. Within months, the teen was feeling much better, and her self-harm behaviors and suicidal ideation dissipated, Fowler says. Although her parents still have to monitor her cell phone use, the client’s situation has greatly improved.

“All of that contention, seemingly overnight, went away,” Fowler says. “I know that the changes that the parents made were a huge factor in helping the child.”

It “took some convincing” for the father to change, Fowler recalls. His frustration toward his daughter stemmed from feeling that she was being unsafe online and making herself available to strange men. Ultimately, Fowler used those feelings as leverage to explain that he had a chance to be the safe man in his daughter’s life.

“That was the window that helped him see … [and] understand how he had the opportunity [to make] his daughter feel loved,” Fowler says. 

Setting boundaries

Boundary setting is one of the most important coping mechanisms a counselor can provide to clients who are surrounded by unhealthy patterns. Even though clients cannot control a loved one’s behavior, they can control the boundaries they choose to establish in the relationship, Ohlund notes. This work must be client led and will look different for each person, based on their preferences and needs.

Exploration of boundaries is best done in session when the environment is calm — before the client needs to confront a loved one in the heat of the moment. Clients should not set a boundary until they are comfortable enforcing it, Ohlund stresses. The counselor and client should also talk through what it will feel like to enforce the boundary, including understanding and preparing for the possibility that it may make the other person feel worse, including triggering anxiety or feelings of abandonment.

Sometimes people may not understand these new boundaries. “Those who benefit from not having boundaries won’t want to deal with what’s going on with them and are going to fight it a lot,” Ohlund points out.

Ohlund often works with clients to establish boundaries that have stages that are customizable if or when a situation arises. For example, if a client has a spouse or family member who is prone to critical or angry outbursts, the first step might be for the client to leave the room or go to another part of the house. If the behavior continues, the client could leave the house for a brief time. Similarly, they could choose to temporarily block the phone number of a family member who is prone to sending a barrage of text messages when that person is upset.

“This is much better than just asking them to stop. What will you do when [the behavior] doesn’t stop? We have to set a boundary that we have control over so we don’t get sucked in or pulled in,” she says. 

Ohlund once had a client whose mother did not approve of some of the ways he and his partner chose to parent their children. She would repeatedly overstep her bounds and impose her opinions on the children. The situation pitted the client’s children against him, Ohlund says.

The mother continued the behavior even though her son spoke with her about it multiple times. Eventually, with Ohlund’s support, he set a boundary that if his mother continued to disparage his parenting style to his children, he would cut off his family’s contact with her for one month.

The mother did not stop her behavior, so the client followed through and cut off contact. During that time, his mother criticized him to other members of their extended family. “He knew it was the right decision, even though it was tough,” Ohlund says. “Eventually, the mom did come around, although it took a considerable amount of time to come to that point.”

This client’s decision to hold firm to his boundary resulted in a positive outcome, but that isn’t always the case. Sometimes people don’t agree with the boundary, which can create a disconnect or distance in the relationship, Ohlund says. “The reality is that [people] don’t have control over whether someone else is going to respond or not respond. It can be very disheartening and something to grieve and think of as a loss. It’s something you are working very hard on, but it’s out of your control,” she notes.

Collier stresses that the goal of boundary setting should be to guide clients to find what’s best for their own mental health, based on their principles. It also involves reflecting on what has and hasn’t worked in the past.

“The goal is not to get the [other] person to change. That’s very important [to understand]. If you are doing something out of your own principle, then it doesn’t matter how the other person responds. You want to say it to them not because it will help them or prompt change but because it’s your principle. It will only work when the [client] has done their own principled thinking,” Collier says. She advises counselors to ask good questions and stay out of the client’s emotional process: “Don’t jump in and become involved in [a client’s] emotions. Just get them thinking about ways to do things differently.”

Lucci agrees that effective boundaries must be rooted in a client’s values. Part of this process may involve having a wider conversation on what the client’s relationship standards are, including what they want out of the relationship and what they feel is required to continue the relationship.

“Setting boundaries can be extremely uncomfortable for people, and that’s why I emphasize that [boundaries] continually change and can be adjusted,” Lucci says. “[This process] is not one session. It’s a very slow process, and it’s adjust, adjust, adjust.”

Clients who are working to establish boundaries may find it helpful to practice the necessary conversations with a counselor before initiating them with loved ones. For example, what might it feel like not to respond to a text from that person? Collier notes that a counselor can talk this scenario through with a client, acknowledge how hard it will be and assess whether it feels like the right thing to do. “Know that there is going to be an uncomfortableness; saying no is going to be hard,” Collier acknowledges. 

It may also be helpful to focus on communication techniques with these clients, including how to bring up sensitive or triggering topics with a loved one in a nondefensive way, Lucci adds. Counselors and clients can practice taking in comments and information from loved ones and then expressing themselves without spurring debate or becoming defensive. In this vein, Lucci sometimes encourages clients to write a dialogue down and read it back to her in session.

“It’s natural to get really anxious about these conversations, and a counselor can help alleviate some of that anxiety by preparing [with the client],” Lucci explains. She asks clients what the goal of the conversation is and how they want to approach it. “It’s really important to listen to what the client wants,” she says. “I want the client to feel empowered and have knowledge, but ultimately it’s their own decision” regarding how to handle the situation.

The counselor’s role

Counselors play an important role in helping clients whose mental health is negatively affected by the toxic patterns of others in their lives. These patterns may indicate that the other person needs counseling themselves, but first and foremost, the counselor’s ethical duty is to help their client, regardless of whether it is appropriate or possible to involve family members or others in their counseling sessions. (An important caveat is when counselors take measures to protect clients from “serious and foreseeable harm.” See Standard B.2.a. of the 2014 ACA Code of Ethics.)

“It’s not ever my job to diagnose someone I don’t know and those who aren’t a client of mine,” Lucci says. “But I can listen and hear the behaviors described by the client and how it’s affecting them. Then, we focus on how [the client] can deal with those behaviors. I don’t ever want to assume how someone is feeling or what’s going on. … Most of all, I want people to feel connected and come to decisions about change on their own.”

Counselors can also equip clients in these situations with resources and serve as support while they decide what they want the relationship to look like, Ohlund adds. But this work will take patience on the part of the counselor, she notes.

“As a counselor, sometimes we can see really far ahead. We can see really clearly what needs to be done in a situation, but it may take a client a very long time to get there,” Ohlund says. “Sometimes it’s easy to feel frustrated: Why can’t they see [it]? Why do they keep these patterns?” 

She advises counselors to be patient and not feel like they are doing things wrong. Instead, “be assured that you’re doing all you can to support a client, and that’s what they need — they may have never had that in their life,” she says.

Similarly, Collier feels her role is to sit with clients and ask questions to help them explore emotions and come to realizations about their situation. Her focus is on the process rather than the symptoms that bring clients into counseling. “I’m interested in how the person is thinking about the problem and the challenge, what has worked and what hasn’t worked, what they’ve tried and how they understand it,” Collier says.

Counselors also need to work through relationship struggles in their own lives to better support clients who are seeking help for similar issues, Collier stresses.

“The client’s ability to change and really think about their situation is only going to be as good as that person who is sitting in the room with them and their ability to see and think about situations,” Collier says. “Our level of maturity lends itself to what will really help a person, and that comes from really examining relationships and patterns in our own lives. That is above and beyond any technique or anything that I can do with a client. We all have problems in our own lives and our relationships, and we need to work on those so we can help clients and think objectively.”

 

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Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.